State faces dire OB-GYN shortage, but lawmakers won’t expand role of nurse-midwives

Affordable homes with ample lots lure many families to the town of Apple Valley in the Mojave Desert. But amenities are limited—no department stores, no Costco and, more importantly, few affordable medical care options for pregnant women. For Cassandra Lindstrom, that meant scheduling the birth of her second baby at a hospital at least an hour away via busy Cajon Pass.

“I was worried that I wouldn’t make it in time and give birth on the freeway,” she said.

Her situation is mirrored by countless other women in a state with a severe shortage of obstetricians and gynecologists. Eight California counties—particularly those in the far north and east—lack even one licensed obstetrician-gynecologist, and 11 other counties have a handful or fewer, according to the state’s Health and Human Services Department.

Certified nurse-midwives, who help ease the load, have been arguing that they could do more. But they are restrained by the fact that California is one of just six states requiring them to work only for a physician, and under a physician’s supervision. A bill that would have expanded their reach by permitting nurse-midwives to work independently almost cleared the Legislature, but failed in the waning hours of the legislative session, after fierce last-minute opposition from the doctors’ lobby.